, ( ..... "'- I "" "I .-........ I I / 0 1 \ :/I' 3 bll .' .ßl .Ql J1J j rf' ; i , t\A '\)B AGS 1\lJT\1t \\CA1E" ... ... ........ PAUL N Oll\ . . being poised upon "a tiny platform. . . above the abyss." Clivès loquacity, his al- most compulsive need to talk and keep conversations going, served to maintain a precarious platform, and when he came to a stop the abyss was there, waiting to en- gulfhim. This, indeed, is what happened when we went to a supermarket and he and 1 got separated briefly from Deborah. He suddenly exclaimed, "I'm conscious now . . . . Never saw a human being be- fore. . . for thirty years. . . . 1 t' s like death!" He looked very angry and dis- tressed. Deborah said the staff calls these grim monologues his "deads" -they make a note of how many he has in a day or a week and gauge his state of mind by their number. Deborah thinks that repetition has slightly dulled the very real pain that goes with this agonized but stereotyped complaint, but when he says such things she will distract him immediately. Once she has done this, there seems to be no lingering mood-an advantage of his amnesia. And, indeed, once we returned to the car Clive was off on his license plates again. B ack in his room, 1 spotted the two volumes of Bach's "Forty-eight Pre- ludes and Fugues" on top of the piano and asked Clive if he would play one of them. He said that he had never played 104 THE NEW YORKER, SEPTEMBER 24, 2007 any of them before, but then he began to play Prelude 9 in E Major and said, "1 re- member this one." He remembers almost nothing unless he is actually doing it; then it may come to him. He inserted a tiny, charming improvisation at one point, and did a sort of Chico Marx end- ing, with a huge downward scale. With his great musicality and his playfulness, he can easily improvise, joke, play with any piece of music. His eye fell on the book about cathe- drals, and he talked about cathedral bells-did 1 know how many combina- tions there could be with eight bells? "Eight by seven by six by five by four by three by two by one," he rattled off "F ac- torial eight." And then, without pause: "That's forty thousand." (1 worked it out, laboriously: it is 40,320.) 1 asked him about Prime Ministers. Tony Blair? Never heard of him. John Major? No. Margaret Thatcher? Vaguely familiar. Harold Macmillan, Harold Wil- son: ditto. (But earlier in the day he had seen a car with 'JMV' plates and instantly said, 'John Major Vehicle"-showing that he had an implicit memory of Major' s name.) Deborah wrote of how he could not remember her name, "but one day someone asked him to say his full name, and he said, 'Clive David Deborah Wear- ing-funny name that. 1 don't know why my parents called me that.'" He has gained other implicit memories, too, slowly pick- ing up new knowledge, like the layout of his residence. He can go alone now to the bathroom, the dining room, the kitchen- but if he stops and thinks en route he is lost. Though he could not describe his residence, Deborah tells me that he un- clasps his seat belt as they draw near and offers to get out and open the gate. Later, when he makes her coffee, he knows where the cups, the milk, and the sugar are kept. He cannot say where they are, but he can go to them; he has actions, but few facts, at his disposal. 1 decided to widen the testing and asked Clive to tell me the names of all the composers he knew. He said, "Han- del, Bach, Beethoven, Berg, Mozart, Lassus." That was it. Deborah told me that at first, when asked this question, he would omit Lassus, his favorite com- poser. This seemed appalling for some- one who had been not only a musician but an encyclopedic musicologist. Per- haps it reflected the shortness of his attention span and recent immediate memory-perhaps he thought that he had in fact given us dozens of names. So 1 asked him other questions on a variety of topics that he would have been knowl- edgeable about in his earlier days. Again, there was a paucity of information in his replies and sometimes something close to a blank. 1 started to feel that 1 had been beguiled, in a sense, by Clive's easy, nonchalant, fluent conversation into thinking that he still had a great deal of general information at his disposal, de- spite the loss of memory for events. Given his intelligence, ingenuity, and humor, it was easy to think this on meet- ing him for the first time. But repeated conversations rapidly exposed the limits of his knowledge. Itwas indeed as Deb- orah wrote in her book, Clive "stuck to subjects he knew something about" and used these islands of knowledge as "step- ping stones" in his conversation. Clearly, Clive's general knowledge, or semantic memory, was greatly affected, too- though not as catastrophically as his ep- isodic memory. Yet semantic memory of this sort, even if completely intact, is not of much use in the absence of explicit, episodic memory. Clive is safe enough in the confines of his residence, for instance, but he would be hopelessly lost if he were to go out alone. Lawrence Weiskrantz comments on the